Obsession: Not as Sexy as it Sounds

I know you’ve been obsessed, so tell me: what’s your poison? What did it for you? Was it an unrequited crush? Some esoteric branch of knowledge you could never quite master? A mop-haired teen idol with the face and vocal range of a neutered kitten? An old grudge you know will never be put right? Trouble at work, at home, in bed, in church? Elder Scrolls V: Skyrim?

Everyone has been in that situation, when you wish you could quit thinking about something. Yet when you say “Stop,” your brain, politely but insistently, says “No.”

I have Obsessive-Compulsive Disorder (OCD). But I want you to consider your own obsessions before we talk about my clinical ones, because the line between the two is not as clean and distinct as you might think. I suffer from debilitating obsessions that can leave me paralyzed by anxiety, and from compulsive ritual behaviors that can consume me for hours at a time. But in their structure (not necessarily in their content, and certainly not in their persistence) my obsessions are quite similar to yours.

You already know what it’s like to be crazy; you just don’t know you know it yet.

Obsession comes from a simple glitch in cognition. Ordinarily, you have a built-in time clock in your mind. After turning over a certain problem for a while, a committee of highly efficient businesspeople in your brain decides, “okay, that’s probably the best solution we can come up with for now,” and they table the issue and move on. That’s healthy and normal.

When you obsess, however, your mind is taken over by a demented executive with the disposition of The Office’s Michael Scott or Parks and Recreation’s Leslie Knope, she of the 48-hour telethon. So, as if hijacked by an NBC sitcom character, your mind refuses to admit defeat, to accept that you just can’t come up with a better answer. After all, what’s the harm in thinking about it just a little more? And more again? A sliver of doubt persists that you haven’t examined the issue from every angle; and so you wrestle with your problem a little longer, trying to find a new solution that reduces your uncertainty and leaves you satisfied.

‘Obsession’ is kind of a sexy word; it evokes models in cologne advertisements, with tight, white underpants and bedroom eyes. Yet the experience of being obsessed is irritating and embarrassing, like having to wear that underwear yourself. For most people, that’s as far as it goes, and obsession is a fleeting annoyance that passes quickly. Obsessive-compulsives are less fortunate. We are taken in, every time, by the promise of one more look at the problem, even if we’ve already worked on it for hours, days, months. (Etymological fact of the day: according to Merriam-Webster, “obsess” derives from the Latin obsessus, which means “to besiege.”)

Sometimes this results in physical, visible compulsions. If we are obsessed with the possibility of catching a disease we may wash our hands over and over again. If we are frightened of hell, we may run our rosary until the chain snaps. But these physical compulsions, which so many assume are the greatest burden of OCD, may be only modest indicators of a terrible internal struggle.

Some of the most distressing forms of OCD have no visible signs, no tangible compulsions. I happen to manage a variant of the disorder referred to as “Pure O,” or purely obsessional OCD, characterized by runaway intrusive thoughts. With Pure O, the mind is held captive by its worst nightmares: fears that the world is about to end, for instance, or that the sufferer is a murderer or a sexual deviant who could succumb to uncontrollable violent urges at any moment.

With Pure O, these problems cannot be put to rest through physical rituals like hand-washing or counting. Instead, the sufferer is left obsessing, silently and almost continuously, incapable of finding conclusive proof that these hideous scenarios will not occur. We cannot tell anyone, for fear of being labeled paranoid or psychotic, and because our symptoms are internal, we are rarely offered aid.

If a sadistic billionaire decided to gather every Pure O sufferer into an Arkham City of twitching misery, then (according to Lee Baer’s The Imp of the Mind) it would be the fourth-largest metropolis in the United States. Yet the disorder continues to be under-diagnosed. It is the invisibility of the disease that gives it power: because so few can recognize our symptoms and because so many do not understand them, many of us struggle for decades before successful diagnosis.

OCD sufferers aren’t straight-jacketed neurotics or treacherous psychopaths or lovable buffoon detectives. We are people who suffer, in a way that is familiar to almost everyone, but to a degree that no one should have to endure. I lost the first twenty years of my life to OCD but I hope that, by continuing to spread awareness of the nature of the disorder, we can bring it out of the shadows and work to alleviate the suffering of so many.

Copyright, Fletcher Wortmann, 2012.

Author of Triggered: A Memoir of Obsessive-Compulsive Disorder (St. Martin’s Press), named one of Booklist’s “Top 10 Science & Health Books of 2012”.

I read quite a bit about psychology and have a bachelors degree in psych, but I had never heard of "pure O" before. That's a very helpful concept for me because my sister was recently diagnosed with OCD and I noted that it was odd that she didn't seem to have the compulsions I associated with OCD.

And I also have trouble with obsessive-intrusive thoughts, though to me, they sometimes seem a bit like Tourette where odd words will just fly into my head, and then that will reoccur at odd times. Every few days the new odd word or phrase will just randomly pop into my consciousness. It's similar to the way Tourette people will just blurt out an odd word, but for me it stays in my head. And I obsess on problems, too, and almost consciously create (sometimes imaginary) bigger problems to distract me from problems that are too painful to obsess on.

I also perseverate, which is similar to obsessing, but it not usually painful (at least not for me).

Does OCD, or obsession, interrelate with depression some how? The way the anxiety does?
My therapist told me that when my brain gets stuck and circles around and around and around the same thought pattern, it's a symptom of depression. And my depression comes with anxiety, so it's usually something like "What if that person comes into my house and kills me?" "I'd go get a knife from the kitchen." "I should lock and dead-bolt the door." Etc., etc.
Sometimes it's less scary, like "Maybe I've got OCD." And then I spend the whole afternoon reading about it online. (Oh, the internet is bad for me.)
My brain just gets stuck on scary thoughts. What gives? What's up? Can you point me towards a name for this phenomenon?

Also, I didn't realize that OCD came with a sort of logic to it's ritual. I wash my hands BECAUSE I want to get bacteria off.
Popular culture makes it seem different, like the world has to be compulsively "just so" for some reason. The markers lined up in rainbow order, the pictures straight on the walls, the books evenly spaced on the desk. But that now sounds more to me like a behavior intended to limit sensory input? Limit the unexpected? Exert control over one's surroundings to a very high degree?